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中华普外科手术学杂志(电子版) ›› 2021, Vol. 15 ›› Issue (06) : 676 -679. doi: 10.3877/cma.j.issn.1674-3946.2021.06.025

论著

腹腔镜胰十二指肠切除术后严重并发症的影响因素研究
王晓磊1,()   
  1. 1. 110000 沈阳市,中国医科大学附属盛京医院普外科
  • 收稿日期:2020-12-03 出版日期:2021-12-26
  • 通信作者: 王晓磊

The analysis of the influential factors of severe complications after laparoscopic pancreatoduodenectomy

Xiaolei Wang1,()   

  1. 1. Department of General Surgery, Shengjing Hospital Affiliated to China Medical University, Liaoning 110000, China
  • Received:2020-12-03 Published:2021-12-26
  • Corresponding author: Xiaolei Wang
  • Supported by:
    Liaoning Provincial Key R & D Guidance Plan(2017202008); Liaoning Provincial Science and Technology Project(20180580478)
引用本文:

王晓磊. 腹腔镜胰十二指肠切除术后严重并发症的影响因素研究[J/OL]. 中华普外科手术学杂志(电子版), 2021, 15(06): 676-679.

Xiaolei Wang. The analysis of the influential factors of severe complications after laparoscopic pancreatoduodenectomy[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(06): 676-679.

目的

探讨腹腔镜胰十二指肠切除术后严重并发症的影响因素。

方法

回顾性分析2017年6月至2020年6月行腹腔镜胰十二指肠切除术(LPD)治疗的120例患者的临床资料。观察患者术后并发症的发生情况,并对其严重程度进行Clavien.Dindo分级。数据统计处理采用SPSS 22.0软件,单因素用卡方检验,多因素用Logistic回归分析。分析严重并发症的发生等15个临床因素的关系,P<0.05为差异有统计学意义。

结果

120例患者中出现并发症共计34例(28.3%),其中严重并发症14例(11.7%)。单因素分析结果显示,患者的年龄>60岁、术前Alb<35.7 g/L、吻合方式、术中出血量>300 ml、术中输血量>800 ml及胰腺质地软是LPD术后严重并发症发生的影响因素(P<0.05)。多因素结果显示,患者年龄>60岁、术中输血量>800 ml、套入式吻合方式及胰腺质地软是LPD术后严重并发症发生的独立影响因素(P<0.05)。

结论

患者年龄>60岁、术中输血量>800 ml、套入式吻合方式及胰腺质地软是LPD术后严重并发症发生的影响因素。

Objective

To investigate the influencing factors of severe complications after laparoscopic pancreaticoduodenectomy.

Methods

The clinical data of 120 patients who underwent laparoscopic pancreaticoduodenectomy (LPD) from June 2017 to June 2020 were analyzed retrospectively. The incidence of postoperative complications was observed, with classifing the severity by using Clavien. Dindo methods. Statistical analysis were performed by using SPSS 22.0 software. The single factor and multiple factors analysis were performed by using Logistic regression analysis and were examined by using Chi-square test. The relationship between 15 clinical factors was analyzed, such as the occurrence of serious complications. A P value of <0.05 was considered as statistically significant difference.

Results

Among the 120 patients, 34 (28.3%) cases had complications after LPD, while 14 (11.7%) cases with severe complications. Univariate analysis showed that the age of >60 years old, preoperative serum ALB of <less than 35.7 g/L, anastomotic mode, intraoperative blood loss of >300 ml, intraoperative blood transfusion of >800 ml and the soft pancreas were the influential factors of serious complications after LPD (P<0.05). Multivariate results showed that the age of > 60 years old, intraoperative blood transfusion of >800 ml, intussusception anastomosis and soft pancreatic texture were the independent factors affecting the occurrence of serious complications after LPD (P<0.05).

Conclusion

The age of >60 years old, intraoperative blood transfusion of >800 ml, intussusception anastomosis and soft pancreatic texture might be the influential factors of severe complications after LPD.

表1 14例PLD患者术后严重并发症发生情况单因素分析(例)
表2 120例LPD患者术后并发症及Clavien.Dindo分级情况(例)
表3 120例PLD患者术后严重并发症发生情况多因素分析
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